What prescription drugs are being abused and who is abusing them? What drives the economics of the problem? What are prescription drug monitoring programs (PDMPs) and how can these programs effectively share data across states? What role do Patient Review and Restriction programs (PRRs) or “lock-ins” play in curbing abuse? Why are payers concerned about this issue, and what innovations are they using to tackle it?
Grant Baldwin, CDC, spoke about prescription drug abuse epidemic levels and how the abuse of these drugs has emerged into a serious public health and cost issue.
Allan Coukell, Pew Charitable Trusts, described prescription drug monitoring programs and best practices across states.
Jo-Ellen Abou Nader, Express Scripts, discussed what different payers are doing to address opioid abuse.
Sarah Chouinard, a physician at a community health center in West Virginia, highlighted the issue of balancing access to medication and some of the anti-abuse measures.
Ed Howard of the Alliance and Mark Merritt of PCMA co-moderated.
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Contact: Beeta Rasouli firstname.lastname@example.org (202)789-2300
If you were unable to attend the briefing, here are some key takeaways:
**While 49 states and DC have legislation authorizing Prescription Drug Monitoring Programs (PDMPs), their scope and impact varies greatly between states, stated Allan Coukell. Patient Review and Restriction Programs (PRRs) also exist in Medicaid and private plans, but legislation would be required for PRR inclusion in Medicare Part D.
**For every dollar of abused drugs obtained through “doctor shopping,” an additional $41 are wasted on related medical claims, such as emergency room costs, unnecessary x-rays, and CAT scans, according to Jo-Ellen Abou Nader.
**Primary care physicians are not trained to handle chronic pain, stated Dr. Sarah Chouinard. Following implementation of Community Care of West Virginia’s program, which requires patients to meet with an anesthetist to assess pain care needs and maintain a “pain contract,” 30% of patients remained on pain medication, 30% were sent to rehab, 20% received alternative treatment, and 20% failed to maintain their contract.
Full Transcript (Adobe Acrobat PDF)